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Consultant dietitians Anne Holdoway and Mhairi Donald, and teenage and young adult nurse specialist Sam Bartlett, highlight the need to make nutrition a priority in cancer services for young people.

Increasing deployment of fuel cell electric vehicles (FCEVs) has led to implementation of hydrogen quality regulations (ISO 14687:2019) to prevent FCEV loss of performance. Hydrogen refuelling stations operators must be able to send representative samples of hydrogen fuel for analysis. Stability of contaminants in sampling vessels needs to be known at ISO 14687:2019 thresholds. A 4-month stability study was carried out on mixtures of ISO 14687 contaminants at amount fractions close to the thresholds in two types of sampling cylinders (SPECTRA-SEAL® and SGS™ aluminium cylinders). SPECTRA-SEAL® cylinder allowed representative sampling of CO, CO2, CH4, C2H6, N2, Ar, He, Cl2CH2, H2O, O2, CH2O2 in hydrogen fuel for 2 months. SGS™ cylinder allowed representative sampling of CO, CO2, CH4, C2H6, N2, Ar, He, Cl2CH2, H2O, O2, H2S for 4 months. Further work is needed to allow representative sampling of ammonia and formaldehyde.

Objectives We set out to characterize patient factors that predict disease activity during the first year of treatment for early inflammatory arthritis (EIA). Methods We used an observational cohort study design, extracting data from a national clinical audit. All NHS organizations providing secondary rheumatology care in England and Wales were eligible to take part, with recruitment from 215/218 (99%) clinical commissioning groups (CCGs)/Health Boards. Participants were >16 years old and newly diagnosed with RA pattern EIA between May 2018 and May 2019. Demographic details collected at baseline included age, gender, ethnicity, work status and postcode, which was converted to an area level measure of socioeconomic position (SEP). Disease activity scores (DAS28) were collected at baseline, three and 12 months follow-up. Results A total of 7455 participants were included in analyses. Significant levels of CCG/Health board variation could not be robustly identified from mixed effects modelling. Gender and SEP were predictors of low disease activity at baseline, three and 12 months follow-up. Mapping of margins identified a gradient for SEP, whereby those with higher degrees of deprivation had higher disease activity. Black, Asian and Minority Ethnic patients had lower odds of remission at three months follow-up. Conclusion Patient factors (gender, SEP, ethnicity) predict disease activity. The rheumatology community should galvanise to improve access to services for all members of society. More data are required to characterize area level variation in disease activity.

Lung cancer is one of the commonest malignancies worldwide and necessitates both early and personalised treatment. A key requirement is histological sampling with immunohistochemistry obtained usually from percutaneous biopsy. Conventionally thoracic biopsies are performed using CT guidance, but more recently, there has been development of physician led ultrasound biopsy for pleural lesions. Contrast-enhanced ultrasound (CEUS) has been increasingly used in interventional procedures and is able to offer benefits for thoracic biopsies including improving lesional visualisation and characterisation, targeting viable tissue and avoiding critical vascular structures as well as evaluating for the presence of post-procedural complications. This educational review aims to benefits of the role of CEUS in thoracic biopsies.

COVID-19 presents an unprecedented challenge to hospitals and the systems in which they operate. The primary exponential surge of COVID-19 cases is arguably the most devastating event a hospital will face. In some countries, these surges during the initial outbreak of the disease have resulted in hospitals suffering from significant resource strain, leading to excess patient mortality and negatively impacting staff wellbeing. As experience builds in managing these surges, it has become evident that agile, tailored planning tools are required. The comprehensive hospital agile preparedness (CHAPs) tool provides clinical planners with six key domains to consider that frequently create resource strain during COVID-19; it also allows local planners to identify issues unique to their hospital, system or region. Although this tool has been developed from COVID-19 experiences, it has potential to be modified for a variety of pandemic scenarios according to transmission modes, rates and critical care resource requirements.

Microbially induced sedimentary structures may help preserve unique glimpses of ancient shoreline habitats, but are little known from Mesozoic epicontinental settings. To help fill this knowledge gap, we describe a diverse suite of microbial structures from the Upper Cretaceous “J” Sandstone (South Platte Formation, Dakota Group) that are spectacularly exposed at Dinosaur Ridge in Morrison, Colorado, USA. Structures include “tattered” bed surfaces and ferruginous sand chips in supratidal flat facies. A large over-flip structure is preserved in a channel locally known as Crocodile Creek. In upper-intertidal facies, multidirectional ripple marks occur. Perhaps the most well-known microbial structures are exposed on extensive bedding surfaces known as “Slimy Beach,” where lower supratidal-flat facies are dominated by decimeter-scale erosional remnants and pockets. Morphologies and superposition of the structures allows identification of three generations of erosional pockets. Generation A of these erosional pockets exhibit size similarities to ornithomimid, sauropod, and ornithopod dinosaur tracks from adjacent bedding planes, raising the question of whether initial disturbance of the mat-bound surface could have been from track making. Generation B erosional pockets are older and record continuous erosion of the initial pockets until they were eventually overgrown and sealed by microbial mats. Generation C pockets are the oldest ones, exposing wide areas of barren sediment that could not be overgrown by microbial mats anymore. In concert, the microbial structures point to seasonally variable meteorological conditions along the coastline of the Western Interior Seaway and indicate that the “Slimy Beach” bedding plane represents a multi-year record of dinosaur locomotion.

The widescale distribution of hydrogen through gas networks is promoted as a viable and cost-efficient option for optimising its application in heat, industry, and transport. It is a key step towards achieving decarbonisation targets in the UK. A key consideration before the injection of hydrogen into the UK gas networks is an assessment of the difference in hydrogen contaminants presence from different production methods. This information is essential for gas regulation and for further purification requirements. This study investigates the level of ISO 14687 Grade D contaminants in hydrogen from steam methane reforming, proton exchange membrane water electrolysis, and alkaline electrolysis. Sampling and analysis of hydrogen were carried out by the National Physical Laboratory following ISO 21087 guidance. The results of analysis indicated the presence of nitrogen in hydrogen from electrolysis, and water, carbon dioxide, and particles in all samples analysed. The contaminants were at levels below or at the threshold limits set by ISO 14687 Grade D. This indicates that the investigated production methods are not a source of contaminants for the eventual utilisation of hydrogen in different applications including fuel cell electric vehicles (FCEV’s). The gas network infrastructure will require a similar analysis to determine the likelihood of contamination to hydrogen gas.

Hydrogen delivered at hydrogen refuelling station must be compliant with requirements stated in different standards which require specialized sampling device and personnel to operate it. Currently, different strategies are implemented in different parts of the world and these strategies have already been used to perform 100s of hydrogen fuel sampling in USA, EU and Japan. However, these strategies have never been compared on a large systematic study. The purpose of this paper is to describe and compare the different strategies for sampling hydrogen at the nozzle and summarize the key aspects of all the existing hydrogen fuel sampling including discussion on material compatibility with the impurities that must be assessed. This review highlights the fact it is currently difficult to evaluate the impact or the difference these strategies would have on the hydrogen fuel quality assessment. Therefore, comparative sampling studies are required to evaluate the equivalence between the different sampling strategies. This is the first step to support the standardization of hydrogen fuel sampling and to identify future research and development area for hydrogen fuel sampling.

International audience; Maritime transport is investigating several options to reduce its greenhouse gases and air pollutant emissions. An experimental ship, Energy Observer, is using excess renewable energy to generate onboard hydrogen by electrolysis of purified seawater. As a promising option for storing energy, it can provide on-demand energy to the ship through a hydrogen fuel cell (FC). As hydrogen FCs lifetime and performance are correlated to hydrogen quality, the hydrogen produced onboard needs to be monitored. This study assesses the probability of contaminants presence for this electrolyser, using purified seawater and supports the results with a hydrogen fuel quality analysis from the Energy Observer ship. It demonstrates that an electrolyser using onboard purified seawater can generate hydrogen of a quality compliant with ISO 14687:2019. Additional contaminants (i.e., ions, heavy metal) were also measured. The study highlights the potential contaminants to be monitored and future research on new contaminants from seawater to further develop hydrogen fuel for maritime applications.

Impurities in carbon dioxide can affect several aspects of the carbon capture and storage process, including storage capacity, rock erosion, accuracy of flow meters, and toxicity of potential leaks. There is an industry need for guidance on performing purity analysis before carbon dioxide is transported and stored. This paper reviews selected reports that specifically provide threshold amount fraction limits for impurities in carbon dioxide for the purpose of transport and storage, with rationales for these limits. A carbon dioxide purity specification is provided (including threshold amount fractions of impurities) on the basis of the findings, as well as recommendations on further work required to develop a suitable gas metrology infrastructure to support these measurements including primary reference materials, sampling methods, and instruments for performing purity analysis. These recommendations provide important guidance to operators and gas analysis laboratories for performing quality assurance.

To meet carbon emissions reduction targets heat and transport need to be decarbonised. Hydrogen is being considered as a flexible energy vector that could play an important part in this endeavour. With demonstration projects on the rise it is crucial to identify suitable odorants to ensure, safety regulations are met and public acceptance gained. Specifically, this work investigates the use of sulphur based odorants currently in use in the UK and Europe, alongside sulphur-free and experimental ones, for use in a 100% hydrogen gas demonstration network in the UK. Gas samples odorised with five different odorants are analysed to determine odour detection threshold, the odour intensity, its hedonic tone and character. The tests are performed by an accredited laboratory following EU standards. The results show that four odorants meet requirements as stenching agents for use in UK gas distribution network, whilst one, 5-ethylidene-2-norbornene, fails to demonstrate an unpleasant odour.

Main text At the highest metrological level, ammonia gas standards are commonly prepared gravimetrically as Primary Standard Mixtures or using a dynamic standard. This international key comparison addressed the measurement of the amount fraction ammonia in nitrogen, to support calibration and measurement services for mainly environmental applications. The nominal amount fraction was 14 μmol mol-1. The results in this Track C key comparison on the composition of biogas are generally good. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database https://www.bipm.org/kcdb/. The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

The absence of contaminants in the hydrogen delivered at the hydrogen refuelling station is critical to ensure the length life of FCEV. Hydrogen quality has to be ensured according to the two international standards ISO 14687–2:2012 and ISO/DIS 19880-8. Amount fraction of contaminants from the two hydrogen production processes steam methane reforming and PEM water electrolyser is not clearly documented. Twenty five different hydrogen samples were taken and analysed for all contaminants listed in ISO 14687-2. The first results of hydrogen quality from production processes: PEM water electrolysis with TSA and SMR with PSA are presented. The results on more than 16 different plants or occasions demonstrated that in all cases the 13 compounds listed in ISO 14687 were below the threshold of the international standards. Several contaminated hydrogen samples demonstrated the needs for validated and standardised sampling system and procedure. The results validated the probability of contaminants presence proposed in ISO/DIS 19880-8. It will support the implementation of ISO/DIS 19880-8 and the development of hydrogen quality control monitoring plan. It is recommended to extend the study to other production method (i.e. alkaline electrolysis), the HRS supply chain (i.e. compressor) to support the technology growth.

A novel method for the analysis of total sulphur-containing impurities in a hydrogen matrix has been developed. This method has a limit of detection (LoD) significantly lower than that maximum amount fraction for sulphur-containing compounds (4 nmol mol(-1)) specified by the international standard for hydrogen to be used in fuel cell vehicles (ISO 14687-2). To measure the LoD for this method, a novel gas standard containing five different sulphur-containing compounds at low nmol mol(-1) amount fractions has been gravimetrically prepared. Stable primary gas standards that are traceable to the SI were used to successfully validate the amount fractions of the sulphur-containing compounds in this gas standards using gas chromatography with flame ionisation detection (GC-FID) and sulphur chemiluminescence detection (GC-SCD).

Biogas is a renewable energy source with many different production pathways and various excellent opportunities to use, for example as vehicle fuel (biomethane). Reliable analytical methodologies for assessing the quality of the gas are critical to ensure that the gas can technically and safely be used. An essential part of any procedure aiming to determine the quality is the sampling and the transfer to the laboratory. One of the greatest challenges is then to ensure that the composition of the sample collected does not change between the time of sampling and the analysis. The choice of the sampling vessel to be used must be made only after fully assessing its short-term stability. In this paper, the results from short-term stability studies in different vessels (cylinders, bags and sorbents) are presented for siloxanes, BTEX, halogenated hydrocarbons and sulfur compounds. Storage of dry gas at high pressure (> 6 MPa) appears to be a good alternative however it is currently challenging to find an optimal treatment of the cylinders for all species to be assessed in biogas/biomethane. At lower pressure, adsorption effects on the inner surface of the cylinders have been observed. The use of bags and sorbent tubes also shows limitation. No existing sorbent tubes are sufficiently universal as to trap all possible impurities and high boiling compounds may adsorbed on the inner surface of the bags walls. Moreover, the presence of water when storing biogas most certainly impacts the storage stability of compounds in most vessels. Using at least two sampling methods for a given compound and comparing results will allow taking into account the eventual effects of water vapour, and adsorption on the inner surface of the vessels.of vessels and adsorbents for the short-term storage of biogas/biomethane for the determination of impurities - Siloxanes, sulfur compounds, halogenated hydrocarbons, BTEX

This key comparison aims to assess the core capabilities of the participants in gas analysis. Such competences include, among others, the capabilities to prepare primary standard gas Mixtures (PSMs), perform the necessary purity analysis on the materials used in the gas mixture preparation, the verification of the composition of newly prepared PSMs against existing ones, and the capability of calibrating the composition of a gas mixture. According to the Strategy for Key Comparisons of the Gas Analysis Working Group, this key comparison is classified as a track A key comparison, which means that the results of this key comparison can be used to underpin calibration and measurement capabilities using the flexible scheme, and for propane under the default scheme. The artefacts were binary mixtures of propane in nitrogen at a nominal amount-of-substance fraction level of 1000 μmol/mol. The values and uncertainties from the gravimetric gas mixture preparation were used as key comparison reference values (KCRVs). Each transfer standard had its own KCRV. The results are generally good. All results but one are within ± 0.2 % of the KCRV. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCQM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

Doctors in Australia work fewer hours and are paid better than their UK counterparts. They can also go surfing before work. So why does Sam Bartlett want to return to the NHS?